Increase In Testicular Volume Research Articles

Pediatrik makroorşidizm

Macroorchidism is defined as an increase in testicular volume at least twice the normal for age. It is a rare condition and its exact incidence is unknown. Although macroorchidism is relatively rare, when it is seen, causes such as genetic, endocrine, neoplasm or testicular torsion should be investigated. With this review, information on diagnosis, treatment and follow-up will be given, especially in the presence of macroorchidism seen in children, by emphasizing possible causes, especially McCune-Albright, Fragile X syndromes and hypothyroidism. Keywords: macroorchism, children, McCune-Albright syndrome, Fragile-X syndrome, hypothyroidism

New Findings on the Sperm Structure of Tenebrionoidea (Insecta, Coleoptera).

Simple SummaryTenebrionoidea, with more than 30,000 described species and 30 currently recognized families, is a superfamily of difficult taxonomy. The aim of this work is to support the basal position of the Mordellidae among the beetle tenebrionoids. They have a low number of sperm cells per cysts, contrary to the more derived families of the group; moreover, their sperm are not distributed in two bundles at the opposite poles of the cysts, as occurs in the higher taxa, but their sperm flagella form a loop in the median region so that sperm nuclei are positioned close to the tail end. The sperm structure of two members of higher families, Oedemeridae and Tenebrionidae, are investigated to confirm the data mentioned above. The sperm looping, which also occurs in the closely related Ripiphoridae, could be the consequence of the growth asynchrony between the cyst size and the sperm length. The Mordellidae sperm are characterized, not by small mitochondrial derivatives and accessory bodies, but by a peculiar stiff and immotile thin flagellar posterior region provided with only accessory tubules.The sperm ultrastructure of a few representative species of Tenebrionoidea was studied. Two species belong to the Mordellidae (Mordellistena brevicauda and Hoshihananomia sp.), one species to Oedemeridae (Oedemera nobilis), and one species to Tenebrionidae (Accanthopus velikensis). It is confirmed that Mordellidae are characterized by the lowest number of spermatozoa per cyst (up to 64), a number shared with Ripiphoridae. In contrast, in the two other families, up to 512 spermatozoa per cyst are observed, the same number present, for example, in Tenebrionidae. Also, as in the other more derived families of tenebrionoids studied so far, during spermatogenesis in O. nobilis and A. velikensis, sperm nuclei are regularly distributed in two sets at opposite poles of the cysts. On the contrary, the Mordellidae species do not exhibit this peculiar process. However, during spermiogenesis, the bundles of sperm bend to form a loop in their median region, quite evident in the Hoshihananomia sp., characterized by long sperm. This process, which also occurs in Ripiphoridae, probably enables individuals to produce long sperm without an increase in testicular volume. The sperm looping could be a consequence of the asynchronous growth between cyst size and sperm length. The sperm ultrastructure of the Mordellidae species reveals that they can be differentiated from other Tenebrionoidea based on the shape and size of some sperm components, such as the accessory bodies and the mitochondrial derivatives. They also show an uncommon stiff and immotile posterior flagellar region provided with only accessory tubules. These results contribute to a better knowledge of the phylogenetic relationship of the basal families of the large group of Tenebrionoidea.

Puberty induction with recombinant gonadotropin: What impact on future fertility?

Congenital hypogonadotropic hypogonadism (CHH) is a group of rare diseases characterized by inadequate secretion of the gonadotropins LH (luteinizing hormone) and FSH (follicle stimulating hormone) during the physiological activation periods of the gonadotropic axis. The disease? (anomaly) is present from fetal life and usually persists throughout life. Clinically, hypogonadotropic hypogonadism is associated with neonatal clinical signs (micropenis, cryptorchidism in boys in about half of the cases). The diagnosis is sometimes only evoked in the presence of an absence or arrest of pubertal maturation in the adolescent, which is often poorly tolerated physically and psychologically. Different therapeutic options for pubertal induction have been described, but we lack the necessary larger randomized trials to define the best approaches for both sexes. Historically, congenital hypogonadotropic hypogonadism diagnosed at puberty is treated with testosterone injections. These injections allow the development of secondary sexual characteristics, without an increase in testicular volume in severe forms (FSH deficiency), and a pubertal statural peak. During the last twenty years, studies have underlined the beneficial role of recombinant gonadotropins to induce puberty in this population for future fertility. This is what we will develop.

Predictors of reproductive and non-reproductive outcomes of gonadotropin mediated pubertal induction in male patients with congenital hypogonadotropic hypogonadism (CHH)

PurposeTo investigate predictors of testicular response and non-reproductive outcomes (height, body proportions) after gonadotropin-induced puberty in congenital hypogonadotropic hypogonadism (CHH).DesignA retrospective analysis of the puberty induction in CHH male patients, undergoing an off-label administration of combined gonadotropin (FSH and hCG).MethodsClinical and hormonal evaluations before and during gonadotropin stimulation in 19 CHH patients genotyped by Targeted Next Generation Sequencing for CHH genes; 16 patients underwent also semen analysis after gonadotropins.ResultsA lesser increase in testicular volume after 24 months of induction was significantly associated with: (I) cryptorchidism; (II) a positive genetic background; (III) a complete form of CHH. We found no significant correlation with the cumulative dose of hCG administered in 24 months. We found no association with the results of semen analyses, probably due to the low numerosity. Measures of body disproportion (eunuchoid habitus and difference between adult and target height: deltaSDSth), were significantly related to the: (I) age at the beginning of puberty induction; (II) duration of growth during the induction; (III) initial bone age. The duration of growth during induction was associated with previous testosterone priming and to partial forms of CHH.ConclusionsThis study shows that a strong genetic background and cryptorchidism, as indicators of a complete GnRH deficiency since intrauterine life, are negative predictors of testicular response to gonadotropin stimulation in CHH. Body disproportion is associated with a delay in treatment and duration of growth during the induction, which is apparently inversely related to previous androgenization.

Magnified subinguinal varicocelectomy versus conservative methods in treatment of adolescent varicocele

Background Elimination of varicocele in adolescent with lower complication rates is the best treatment modality. Therefore, the ideal technique should aim to ligate all internal and external spermatic veins with preservation of spermatic arteries and lymphatics. Aim We compared the outcome of magnified subinguinal varicocelectomy versus conservative methods in the treatment of adolescent varicocele. Patients and methods A total of 40 adolescent males (aged between 15 and 19 years) with refluxing varicocele and affected semen parameters and testicular volume were included. Overall, 20 patients were treated by magnified subinguinal varicocelectomy and 20 patients treated by conservative methods. All patients were reevaluated and followed for 6 months by several semen parameters and changes in testicular size by Doppler ultrasound. Results A significant improvement was seen in postmagnified subinguinal varicocelectomy group regarding sperm volume, sperm motility, sperm count, progressive movement, vitality, abnormal morphology, testicular volume, and varicocele grade, but in conservative method group, patients showed significant improvement regarding percent of rapid sperm, progressive movement and vitality, and a slight increase in testicular volume. After 6 months, there was a significant difference between both groups regarding sperm volume, progressive movement, vitality, testicular volume, and varicocele grade, so magnified subinguinal varicocelectomy is superior to conservative methods in the management of adolescents with symptomatic varicocele.

Kallmann syndrome in a 17-year-old boy

Aim. To describe a rare hereditary disease — Kallmann syndrome — in a 17-year-old boy.Materials and methods. A retrospective analysis of anamnestic information, the course of the disease, laboratory and instrumental data and treatment of a 17-year-old patient with Kallmann syndrome was carried out. The patient underwent treatment in a gastroenterological department of the Children’s Regional Clinical Hospital in Krasnodar in March 2019.Results. Patient K., 17 years old, was admitted to the gastroenterological department of the Children’s Regional Clinical Hospital in March 2019 with complaints of weakness, nausea, “hungry” abdominal pain and decreased appetite. Upon examination, the child revealed duodenal ulcer. However, an in-depth examination found that the boy was lagging behind in physical and sexual development. In this connection, an endocrinological examination was performed, which discovered: a decrease in the concentration of sex hormones relative to the age norm (luteinizing hormone, follicle-stimulating hormone, testosterone), delayed bone age as compared to the passport age, discrepancy between the testicular size and the patient’s age, olfactory bulb hypoplasia according to brain MRI, 1st degree smell disorder, the presence of a mutation in the KAL1 gene. The boy was diagnosed with: Kallmann syndrome, X-linked recessive inheritance. Complications: hypogonadotropic hypogonadism. The chosen treatment included prolonged testosterone esters for parenteral administration of 250 mg once per 3–4 weeks. Following 6 months of therapy, positive signs were observed: an increase in height by 2 cm, an increase in testicular volume by 3 ml, the appearance of single hairs at the base of the penis.Conclusion. Kallmann syndrome is a rare pathology, whose main manifestations include delayed sexual development and hypo- or anosmia. For a timely diagnosis and treatment, it is of great importance to identify symptoms and conduct a comprehensive examination. Timely initiation of hormonal treatment allows puberty to occur in all cases, thus facilitating social and psychological adaptation of such patients.

Calcium chloride combined with dimethyl sulphoxide for the chemical sterilization of dogs.

The aim of this study was to evaluate the effect of intratesticular injection of calcium chloride (CaCl2 ) combined with dimethyl sulphoxide (DMSO) as a chemical sterilization in dogs. Twelve dogs were divided into two groups: the treated group (n=6), in which 15mg/kg of a 7.5% CaCl2 solution combined with 0.5% DMSO was injected into each testicle (volume range 1.0-4.76ml); and a control group (n=6) that received the same volume/kg of 0.9% sodium chloride solution (NaCl). Semen characteristics pre- and post-treatment were evaluated. Serum testosterone concentration was determined before the injection (D-1) and at 15 (D15), 30 (D30) and 60 (D60) days after intratesticular injection. Testicle sizes and local pain were evaluated for 7 consecutive days (D1 to D7) and at D15, D30 and D60 after injection. At D60, testicle histological evaluation was performed after orchiectomy. No pain was observed by testicular palpation, with the exception of one dog in the treated group; this dog then received analgesic therapy. An increase in testicular volume was evident within 24hr after treatment, followed by gradual reduction for 3weeks. Five of 6 dogs from the treated group presented azoospermia at D15; the remaining dog presented at D30. There was no significant difference in testosterone concentrations in the treated group during the experimental period. Histological evaluation showed testicular degenerative lesions, especially at the proximal and middle portions. The results indicated that one injection of 7.5% CaCl2 combined with 0.5% DMSO into each testis is a viable alternative for canine sterilization.

Testicular histological evaluation and serum testosterone concentrations of bulls after chemical castration with calcium chloride

ABSTRACT: Orchiectomized bulls have advantages in the meat quality and ease of handling. Chemical castration is an option for surgical castration and the sclerosing agents can be administered into the testicular or epididymis parenchyma. These agents have a lower incidence of complications than surgery, especially when associated with dimethylsulfoxide (DMSO), which has anti-inflammatory action and increases the absorption of other drugs. Thus, this study aimed to evaluate the effect of a single intratesticular injection of calcium chloride solution associated with DMSO for the chemical sterilization of bulls. Twenty-four young adult bulls were utilized, distributed into 3 groups (G20, G30 and G40, n = 8/group), according to the calcium chloride concentration (20, 30 and 40%), in 10mL volume. Serum concentrations of testosterone, body weight, testicular volume and ecotexture, clinical signs and behavior and were evaluated for 45 days. Thus, the animals were orchiectomized and testicles were assessed histologically. There were no changes in body weight, decreased serum testosterone concentrations (except G30), signs of scrotal sensitivity or changes in behavior over the period. However, there was significant increase in testicular volume, especially on the 2nd and 3rd day after treatment, with values returning to the value initials at 15 days. Testicular adherence and firm consistency were observed during orchiectomy. Ultrasound examination revealed a loss of integrity of the median raphe, with cavity formation and an alteration of the testicular echotexture. In the histological evaluation, coagulation necrosis of seminiferous tubules and interstitial cells was observed, mainly in the medial portion in all groups. Some animals presented total absence of tubular formations in all the studied groups, being the effects of greater intensity in the G40. Additionally, pronounced edema was noted in all groups, especially in G40. Inflammatory infiltrate, fibroplasia and neovascularization were found to be predominantly discrete. Based on the conditions used in this study, we conclude that calcium chloride associated with DMSO can be used as a method of chemical sterilization in bovines.

Shortened daily photoperiod during the non-breeding season can improve the reproductive performance of camel bulls (Camelus dromedarius)

The effects of a shortened photoperiod on the reproductive performance and hormones of mature dromedary camel bulls (Camelus dromedarius) were evaluated. A group of 6 bulls were blindfolded to induce a daily photoperiod that was ∼2.55 h shorter than the natural day length (10.83L:13.17D), whereas 6 others served as the control group. The trial started in June and continued for 10 weeks during the non-breeding season. The reproductive performance of all animals was evaluated weekly during this time and also during the breeding season, starting in December and continuing for 10 weeks. Camel bulls in the treatment group showed a significant (p < 0.05) increase in testicular volume, scrotal circumference, sexual desire, reaction time, and mating ability scores, and serum melatonin and testosterone concentrations, relative to the control group, during the non-breeding season. In addition, sexual desire and reaction time and mating ability scores were significantly (p < 0.05) higher in the treatment group than in the control during the breeding season. There was no significant difference between the treatment groups in both seasons and the control group in the breeding season regarding semen volume, sperm cell concentration, total motility, progressive motility, plasma membrane integrity, and viability. Shortening the daily photoperiod by blindfolding can improve the reproductive performance of dromedary camel bulls during the non-breeding season and the following breeding season. This simple, inexpensive, and easily applicable method can enable breeders to collect semen of acceptable quality during the non-breeding season.

Surgical approaches for varicocele in pediatric patient.

Varicocele represents one of the most common surgically correctible urologic anomalies in adolescent males. The best procedure for the treatment of adolescent varicocele has not been established, but with recent advances in minimal access surgery, there have been many reports praising the safety and efficacy of laparoscopy and retroperitoneoscopy for the surgical correction of varicocele in adolescent. The aim of this review is to compare the results of Palomo's technique, with retroperitoneoscopic and transperitoneoscopic approaches in adolescent, analyzing recurrence, testicular growth and complications. A literature search on PubMed and Cochrane Database was conducted with regard to management of varicocele in adolescent population. Twenty two English language studies that compared outcome of different minimally invasive treatments or outcome of minimally invasive and traditional surgical treatments for adolescent diagnosed with varicocele were included. Intraoperative complications of minimally invasive approaches occur in early cases, but in pediatric urology these procedures would become more efficient with experience and these approaches continue to increase in number. Postoperative hydrocele is the most postoperative compliance of Palom technique, and reports have shown a wide range of variability for his incidence, depending on the technique used for surgical treatment. Literature showed an increase of testicular volume for real growth of testis after surgery, and an intratesticular improvement in sperm quality after minimally invasive approach. In laparoscopic approach reports have showed very low recurrence because allows better vision of collateral veins, and a lymphatic sparing technique permit to identify lymphatic vessels in 100% of cases. The literature has shown that laparoscopic varicocelectomy is the surgical approach most commonly reported in adolescent patients, and that its use is increasing for better training for surgeons and the ability to avoid operational hydrocele that is a main complication after technical Palomo's technique.

Effects of melatonin implantation on the fertility potentials of Kivircik and Charollais ewes and rams during the non-breeding season.

This study examined the effect of melatonin implantation during the non-breeding season on the reproductive performance of ewes and the testicular dimensions of rams. In seasonally anestrus Kivircik and Charollais ewes and rams were subjected to melatonin. Estrus response was significantly higher in treated than control ewes of both breeds (p<0.001). The pregnancy rate was significantly lower (p<0.001) in the control than in the treated animals. The twinning rate was significantly lower in melatonin implanted Kivircik than Charollais ewes (p<0.05). The testicular dimensions after 42 days of melatonin treatment increased in both breeds. Scrotal length (SL) increased in Kivircik and Charollais rams (p<0.01). The increase in scrotal circumference (SC) was more marked in the Charollais (P<0.01) than in the Kivircik rams. There was a large increase in testicular volume (TV) in both Kivircik (p<0.01) and Charollais (p<0.001) rams. This study shows that melatonin implants can be applied to induce estrus in ewes approximately four months earlier than breeding season. Melatonin implantation in the non-breeding season significantly increased testicular dimensions in Kivircik and Charollais rams thus increasing their reproductive potential.

An open-label clinical trial to investigate the efficacy and safety of corifollitropin alfa combined with hCG in adult men with hypogonadotropic hypogonadism

BackgroundHypogonadotropic hypogonadism (HH) in men results in insufficient testicular function and deficiencies in testosterone and spermatogenesis. Combinations of human chorionic gonadotropin (hCG) and recombinant follicle-stimulating hormone (recFSH) have been successful in the treatment of HH. Corifollitropin alfa is a long-acting FSH-analog with demonstrated action in women seeking infertility care. The aim of this study was to investigate the efficacy and safety of corifollitropin alfa combined with hCG to increase testicular volume and induce spermatogenesis in men with HH.MethodsThis was a Phase III, multi-center, open-label, single-arm trial of corifollitropin alfa in azoospermic men aged 18 to 50 years with HH. After 16 weeks of pretreatment of 23 subjects with hCG alone, 18 subjects with normalized testosterone (T) levels who remained azoospermic entered the 52-week combined treatment phase with hCG twice-weekly and 150 μg corifollitropin alfa every other week. The increase in testicular volume (primary efficacy endpoint) and induction of spermatogenesis resulting in a sperm count ≥1 × 106/mL (key secondary efficacy endpoint) during 52 weeks of combined treatment were assessed. Safety was evaluated by the presence of anti-corifollitropin alfa antibodies and the occurrence of adverse events (AEs).ResultsMean (±SD) testicular volume increased from 8.6 (±6.09) mL to 17.8 (±8.93) mL (geometric mean fold increase, 2.30 [95% CI: 2.03, 2.62]); 14 (77.8%) subjects reached a sperm count ≥1 × 106/mL. No subject developed confirmed anti-corifollitropin alfa antibodies during the trial. Treatment was generally well tolerated.ConclusionsCorifollitropin alfa 150 μg administrated every other week combined with twice-weekly hCG for 52 weeks increased testicular volume significantly, and induced spermatogenesis in >75% of men with HH who had remained azoospermic after hCG treatment alone.Trial registrationClinicalTrials.gov: NCT01709331.

Diet and Reproductive States in a High Altitude Neotropical Lizard Species,Liolaemus ramirezae(Iguania: Liolaemidae)

Abstract The diet of an animal may be influenced by both its reproductive biology and seasonal changes. Here we investigate these factors in the lizard species, Liolaemus ramirezae, from the prepuna of northwestern Argentina, during spring, summer, and autumn. We found that L. ramirezae eats mainly Hemiptera, Coleoptera, and Formicidae. Considering total plant volume with respect to prey volume, this species was mostly insectivorous. Food intake varied among the different seasons and between the sexes. We recorded males with the greatest increase in testicular volume in spring, most females being gravid at that time. In summer, females were in a previtellogenic state, and in autumn most were previtellogenic with one being vitellogenic. When females were gravid they ate significantly less. In contrast, the relationship between male reproductive state and amount of prey consumed was not as distinct. Therefore, in L. ramirezae, the amount of food consumed by males would not be affected by their reproductive ...

Pubertal Development

Pubertal Development

Outcome of Varicocelectomy with Different Degrees of Clinical Varicocele in Infertile Male

Aim. To evaluate the prevalence and effect of varicocele repair on sperm motility, sperm concentration, testicular volume, and pregnancy rate in different degrees of clinical varicocele.Material and Methods. The case records were retrospectively evaluated for 482 infertile patients with varicocele who underwent varicocelectomy from December 2008 to December 2013. Semen analysis of patient at preoperative and 3-, 6-, and 12-month postoperative period was done. Varicocele was graded as per the World Health Organization grading (WHO 1993) system and included in the study. Testicular volume was noted by ultrasonography in pre- and postoperative period in one-year follow-up. Pregnancy rate was calculated at 3, 6, and 12 months of follow-up.Results. Significant differences were seen in sperm motility and concentration of patients with Grade 3 varicocele as compared with Grade 1 and Grade 2 varicocele. Significant increase in testicular volume was present after one year in Grade 3 varicocele in the postoperative period. There was significant correlation between the testicular volume and the sperm concentration. Percentage of spontaneous pregnancy in 1 year after varicocele treatment was 32 to 41% of cases.Conclusion. Varicocelectomy significantly improved sperm motility, concentration, and testicular volume. There were 32 to 41% of infertile patients who achieved pregnancy spontaneously.

Photoperiodic control of testicular growth, histomorphology and serum testosterone levels in the male Eurasian tree sparrow: Involvement of circadian rhythm

Experiments were performed on the subtropical population of male Eurasian tree sparrow (Passer montanus) to examine the mediation of the circadian rhythms in photoperiodic regulation of reproductive responses. In the first experiment, photosensitive sparrows were exposed to different resonance light dark cycles viz. 6L/6D, 6L/18D, 6L/30D, 6L/42D, 6L/54D and 6L/66D along with a control group under long day length (14L/10D) for 35days. The birds read the cycles of 6L/6D, 6L/30D and 6L/54D as long day and exhibited significant testicular growth and increased testosterone levels while the cycles of 6L/18D, 6L/42D and 6L/66D were read as short day with no testicular response. In the second experiment, groups of photosensitive birds were subjected to various intermittent light dark cycles of 2L/2D, 3L/3D, 4L/4D, 6L/6D, 8L/8D and 12L/12D with two control groups kept under 9L/15D and 14L/10D for 35days. The birds held under the light/dark cycles of 2L/2D, 3L/3D, 4L/4D, 6L/6D and 12L/12D showed testicular growth and increased serum levels of testosterone while those exposed to 8L/8D did not. The responses were significantly higher in the birds exposed to 2L/2D, 3L/3D, 4L/4D and 6L/6D when compared to 12L/12D. Histomorphology of testes revealed different stages of spermatogenesis only under gonadostimulatory light regimes. The germinative epithelium thickness and diameter of seminiferous tubules increase while the thickness of testicular wall and area of interstitial space decrease with the increase in testicular volume. The above results indicate the involvement of an endogenous circadian rhythm in photoperiodic induction of testicular growth and functions.

Effects on normalized testicular atrophy index (TAIn) in cryptorchid infants treated with GnRHa pre and post-operative vs surgery alone: a prospective randomized trial and long-term follow-up on 62 cases.

The aim of this study was to investigate the effects of gonadotropin releasing hormone analog (GnRHa) therapy on normalized testicular atrophy index (TAIn) using gonadorelin before and after orchiopexy. 62 infants with 87 undescended testes (UDT) were prospectively assigned to two homogeneous groups according to age, position of UDT and TAIn. The patients were randomized to receive either orchiopexy alone or orchiopexy combined with GnRHa as nasal spray at 1.2 mg daily for 4 weeks before surgery and 4 weeks after surgery. Surgical approaches were relative to the position of the UDT: Shoemakers technique in proximal-UDT and Bianchi technique in distal-UDT. All the patients were evaluated clinically and sonographically 1 month before surgery, at the time of surgery, 1 month, 6 months and 5 years after surgery. Ultrasound data in our study have shown a statistically significant decrease of TAIn in children given additional HT only after 5 years of follow-up, in unilateral cases and in the entirety of treated patients; in bilateral cases this difference was not statistically significant. Patients with a TAIn >20% treated with preoperative and post-operative GnRHa therapy have a significant increase in testicular volume after 5 years of follow-up, as shown by the relative reduction of TAIn values.

Diet and Reproductive States in a High Altitude Neotropical Lizard,Liolaemus crepuscularis(Iguania: Liolaemidae)

Abstract. Diet and reproduction are two important characteristics in animals that can be related to environmental conditions and time of year. In this study, we investigated these two parameters in a viviparous lizard, Liolaemus crepuscularis, from the arid Prepuna of northwestern Argentina, for two months of the austral spring (October 2009 and November 2010) and one month at the beginning of the fall (March 2010). Formicidae was the main prey item, similar to what was found in other Liolaemus species; but plant material was also very important, especially in the latter month when lizards consumed the greatest amounts of food. In October 2009 and November 2010, testicular volume in males was low whereas females were gravid. In March 2010, males showed a great increase in testicular volume and females showed vitellogenic follicles, indicating reproductive activity. A negative correlation was found in females between amount of food consumed and advancement of pregnancy. Females ate very little while gravid...

Progression of puberty after initiation of androgen therapy in patients with idiopathic hypogonadotropic hypogonadism

Background:Onset of puberty in boys usually occurs by 14 years of age. Some boys may exhibit delayed sexual maturation till about 17-18 years of age. However, pubertal onset beyond 18 years of age is exceedingly rare.Materials and Methods:Patients diagnosed as idiopathic hypogonadotropic hypogonadism (IHH) who had onset of puberty (increase in testicular volume >10 ml) while on androgen therapy were studied. These patients were evaluated prospectively.Results:There were nine subjects that were included in the study. The pre-therapy testicular volumes ranged from 3 to 6 ml. Luteinizing hormone (LH) levels increased from 1.2 ± 0.96 to 2.8 ± 1.0 IU/L, follicular stimulating hormone (FSH) levels increased from 1.5 ± 0.79 to 3.5 ± 1.9 IU/L, and testosterone increased from 0.36 ± 0.16 to 3.4 ± 2.1 ng/ml. Three out of nine patients had testosterone levels below 3 ng/ml.Conclusion:Our present study indicates that pubertal development can occur in patients presenting with hypogonadotropic hypogonadism after 18 years of age. However, acquired pubertal status may be subnormal

Varikozele bei Jugendlichen

Testicular varicocele is present in 15% of adolescent boys. The very impact of this pathology and who will be at risk of developing into infertility remains unclear. Research on the pathophysiology, results of surgical or radiological interventions and potential predictors for long-term impairment of spermatogenesis and thus fertility is still ongoing. Indications for treatment are mainly based on differences in testicular volumes as semen parameters are most often not available; however, whether testicular volume is a valuable prognostic parameter for later fertility remains questionable. Approximately 50% of adolescent patients with varicocele experience spontaneous increase of testicular volume without any intervention.